<div id="page-wrapper-fault">
    <div class="row">
        <div class="col-lg-12">
            <h1 class="page-header">马上报修</h1>
        </div>
        <!-- /.col-lg-12 -->
    </div>
    <!-- /.row -->
    <div class="row">
        <div class="col-lg-12">
            <div class="panel panel-default">
                <div class="panel-heading">
                    报修信息单
                </div>
                <div class="panel-body">
                    <div class="row">
                        <div class="col-lg-6">
                            <form role="form">
                                <fieldset disabled>
                                    <div class="form-group">
                                        <label>姓名</label>
                                        <input class="form-control realName" id="realName-fault" placeholder="姓名">
                                    </div>
                                    <div class="form-group">
                                        <label>手机号</label>
                                        <input class="form-control mobile" id="mobile-fault">
                                        <p class="help-block"></p>
                                    </div>
                                    <div class="form-group">
                                        <label>校区</label>
                                        <select class="form-control area" id="area-fault">
                                            <option value="1">东校区</option>
                                            <option value="2">西校区</option>
                                            <option value="3">北校区</option>
                                        </select>
                                    </div>
                                    <div class="form-group">
                                        <label>单位</label>
                                        <select class="form-control unit" id="unit-fault">
                                            <option value="外国语学院">外国语学院</option>
                                            <option value="会计学院">会计学院</option>
                                            <option value="国际贸易与经济学院">国际贸易与经济学院</option>
                                            <option value="信息与机电工程学院">信息与机电工程学院</option>
                                            <option value="马克思学院">马克思学院</option>
                                            <option value="学务处">学务处</option>
                                            <option value="校办">校办</option>
                                            <option value="现教中心">现教中心</option>
                                        </select>
                                    </div>
                                    <div class="form-group">
                                        <label>建筑楼</label>
                                        <select class="form-control build" id="build-fault">
                                            <option value="行政楼">行政楼</option>
                                            <option value="1号教学楼">1号教学楼</option>
                                            <option value="2号教学楼">2号教学楼</option>
                                            <option value="图书馆">图书馆</option>
                                            <option value="咨询楼">咨询楼</option>
                                            <option value="万林会馆">万林会馆</option>
                                            <option value="广恩楼">广恩楼</option>
                                        </select>
                                    </div>
                                    <div class="form-group">
                                        <label>门牌号</label>
                                        <select class="form-control office" id="office-fault">
                                            <option value="102">102</option>
                                            <option value="103">103</option>
                                            <option value="222">222</option>
                                            <option value="405">405</option>
                                            <option value="406">406</option>
                                            <option value="220">220</option>
                                            <option value="306">306</option>
                                        </select>
                                    </div>
                                </fieldset>
                            </form>
                        </div>
                        <!-- /.col-lg-6 (nested) -->
                        <div class="col-lg-6">
                            <form role="form" action="javascript:void (0)" id="faultForm" onsubmit="return addFault();">
                                <input id="userId" name="userId" type="hidden" th:value="${session.user.userId}">
                                <div class="form-group">
                                    <label>故障类型</label>
                                    <select class="form-control category" name="category" id="category">
                                        <option value="电脑故障">电脑故障</option>
                                        <option value="打印机故障">打印机故障</option>
                                        <option value="电脑连不上网">电脑连不上网</option>
                                        <option value="电脑换系统">电脑换系统</option>
                                        <option value="网线故障">网线故障</option>
                                    </select>
                                </div>
                                <div class="form-group">
                                    <label>备注</label>
                                    <textarea name="comment" class="form-control" rows="3" placeholder="请输入详细信息..."></textarea>
                                </div>
                                <button class="btn btn-primary btn-block">提交信息</button>
                            </form>
                        </div>
                        <!-- /.col-lg-6 (nested) -->
                    </div>
                    <!-- /.row (nested) -->
                </div>
                <!-- /.panel-body -->
            </div>
            <!-- /.panel -->
        </div>
        <!-- /.col-lg-12 -->
    </div>
    <!-- /.row -->
</div>